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HomeMy WebLinkAbout22343-z L R FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23915 Date SEPTEMBER 26, 1995 THIS CERTIFIES that the building ADDITION Location of Property 2775 NARATOOKA ROAD MATTITUCK, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 2 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 28, 1994 pursuant to which Building Permit No. 22343-Z dated SEPTEMBER 23, 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is ADDITION TO EXISTING ONE FAMILY DWELLING AS APPLIED FOR & AS PER ZBA #4267 ATTIC SPACE NON-HABITABLE. The certificate is issued to ANNE M. SHANNON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-363246 - SEPTEMBER 11, 1995 PLUMBERS CERTIFICATION DATED SEPT. 20, 1995-PECONIC PLUMBING & HEATING Bui ding Inspector Rev. 1/81 Y FORM NO. 4 TOWN OF SOUTHOLD BUILDING DEPARTMENT Office of the Building Inspector Town Hall Southold, N.Y. CERTIFICATE OF OCCUPANCY No Z-23916 Date SEPTEMBER 26, 1995 THIS CERTIFIES that the building ACCESSORY Location of Property 2775 MARATOOKA ROAD MATTITUCR, N.Y. House No. Street Hamlet County Tax Map No. 1000 Section 123 Block 2 Lot 26 Subdivision Filed Map No. Lot No. conforms substantially to the Application for Building Permit heretofore filed in this office dated JULY 28, 1994 pursuant to which Building Permit No. 22343-Z dated SEPTEMBER 23, 1994 was issued, and conforms to all of the requirements of the applicable provisions of the law. The occupancy for which this certificate is issued is RELOCATE EXISTING ACCESSORY GARAGE AS APPLIED FOR. The certificate is issued to ANNE M. SHANNON (owner) of the aforesaid building. SUFFOLK COUNTY DEPARTMENT OF HEALTH APPROVAL N/A UNDERWRITERS CERTIFICATE NO. N-363246 - SEPTEMBER 11, 1995 PLUMBERS CERTIFICATION DATED N/A B ld'ng Inspector Rev. 1/81 FORM NO.3 TOWN OF SOUTHOLD 9UILDING DEPARTMENT TOWN HALL SOUTHOLD, N.Y. 13UILDING PERMIT (THIS PERMIT MUST BE KEPT ON THE PREMISES UNTIL FULL COMPLETION OF THE WORK AUTHORIZED) SEPTEMBER 23, 94 N2 22343 Z Date 19..,........ Permisslon Is hereby granted to: ........ANNE M....SAANNON SHAN P.O. BOX 408 NATTITUCR, NY 11952 CONSTRUCT AN ADDITION TO AN EXISTING ONE FAMILY DWELLING AND RELOCATE to EXISTING ACCESSORY GARAGE AS APPLIED FOR. 2 CO'S REQUIRED . MARATOOKA ROAD..................... MATTITUCR....................NY at premises located at ....2775. . County Tax Map No. 1000 Section 123............ Block Z............ Lot No. 26 JUL, pursuant to application dated :Y..28 19..94........., and approved by the Building Inspector. Fee $.4p ~........C.. % uilding Inspector Rev. 6/30/80 i 4 Form No. 6, TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN HALL 765-!802 APPLICATION FOR CERTIFICATE OF OCCUPANCY A. This application must be filled in by typewriter OR ink and submitted to the building inspector with the following: Ear new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. of water supply and sewerage-disposal(S-9 form). 3. Approval of electrical installation from Board of Fire Underwriters. 1. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate-of Code Compliance from architect or engineer, responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. 8. For existing buildings (prior to April 9, 1957) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, streets, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling $25.00, Alterations to dwelling $25.00, Swimming pool $25.00, Accessory building $25.00. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Buildine - $100.00 3. Copy of Certificate of Occupancy - $2o.0U 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial 115.00 Date . New Construction........... Old /O Pre-existing Building ,V" ../.~/i26 W/ .//V~/ Location of Property douse No. Street Hamlet Onwer or Owners of Property.......Ny ~~4!?.......... :ounty Tax Map No 1000, Section Block................ Lot...................... Subdivision ..............Z .........................F~iiled Map............ Lot...................... 7ermit No...ao? 3.Y3.--a Date Of permit....//Y !.......Applic:int ileallh Dept. Approval ..........................Underwriters Approval......................... 'lanning Board Approval '?egvest for: Tempora,r~yy ~Cjertificate........... Final Certicate........... `~.d`-.Lqo .ee Submitted: mi is~ S Farm }1p. TOWN OF SOUTUOLD BUILDING DEPARTMENT TOWN MALL 765-1802 APPLICATION FOR CERTIFICATE OF OCCUPANC': A. This application muse be filled in by typewriter OR ink and submitted cc the budding inspector with the following: for new building or new use: 1. Final survey of property with accurate location of all buildings, property lines, streets, and unusual natural or topographic features. 2. Final Approval from Health Dept. K water supply and sewerage-disposal(S-O form) 3. Approval of electrical installation from Board of Fire Underwriters. G. Sworn statement from plumber certifying that the solder used in system contains less than 2/10 of 1% lead. 5. Commercial building, industrial building, multiple residences and similar buildings and installations, a certificate.of Code Compliance from architect or engineer. responsible for the building. 6. Submit Planning Board Approval of completed site plan requirements. B. For existing buildings (prior to April 4, 1457) non-conforming uses, or buildings and "pre-existing" land uses: 1. Accurate survey of property showing all property lines, screens, building and unusual natural or topographic features. 2. A properly completed application and a consent to inspect signed by the applicant. If a Certificate of Occupancy is denied, the Building Inspector shall state the reasons therefor in writing to the applicant. C. Fees 1. Certificate of Occupancy - New dwelling $25.00, Additions to dwelling 525.00, Alterations to dwelling 525.00, Swimming pool $25.00, Accessory building $25.00. Additions to accessory building $25.00. Businesses $50.00. 2. Certificate of Occupancy on Pre-existing Building - $100.00 3. Copy of Certificate of Occupancy - $20.00 4. Updated Certificate of Occupancy - $50.00 5. Temporary Certificate of Occupancy - Residential $15.00, Commercial =15.00 Date ..../S l New Construction........... Old OAF/ Pre-existing Building ...aw•.......... Property....... //J G' . J.~- 14 b ....../.!/.W/~ f fh/'C Location of douse No. . / Street Hamlet Onwer or Owners of Propert y.....~NN Y AMyIN N73egq 1a3 2-a6 ounty Tax Map No 1000, Section Block................ Lot'........................ Subdivision Khcd Map............ Loc...................... ?ermit No...tiVa~• 7.3:-..Dote Of permit..../j[.! !.......Applicant lieallh Dept. Approval ..........................Underwriters Approval......................... 'lanning Board Approval........................ lequesc for: Temporary ~C/eertificate........... Final Cercicate........... ea Submicad' $....X. 7S d.CQa . - _UN U„Lu I~ ~JaKMLNT° c~ ( LD •J m FOUNDATION c ti FOUNDATION m ~ 2. L , ~f fail z 0 ROUGH FRAME & 1< Av? G' ? PLUMBING 3. m INSULATION PER N. Y. STATE ENERGY CODE x a 4. e LLj _ j C~ FINAL a ~J`?! 77f}f}7~~~ 75 ADDITIONAL COMMENTS: RI x ~ a W H ~ O sz- t*] v H THE NEW YORK BOARD OF FIRE UNDERWRITERS PAGE 1 1001107.1 BUREAU OF ELECTRICITY 85 JOHN STREET. NEW YORK. NEW YORK 10038 Date 9EPTEIIBFR .1.1,1995 Application No. on file 86400494/94 N 363246 THIS CERTIFIES THAT only the electrical equipment as described below and introduced by the applicant named on the above application number in the premises of ANNE SHANNON, 2775 HARATOOKA ROAD, R9ATTITUCK, N.Y. in thefollowing location; 0 Basement ® let FL ® 2nd FL OUT Section Block Lot was examined on SEPTERBER 08 r 1995 and found to be in compliance with the National Electrical Code. FIXTURE FIXTURES RANGES COOKING DECKS OVENS DISHWASHERS EXHAUST FANS OUTLETS ECEPTACLES SWITCHES INCANDESCENT FLUORESCENT OTHER AMT. K. W. "T K. W. AMT K.W, WT. K.W AMT. H.P 28 39 39 1 1„ 5 DRYERS FURNACE MOTORS FUTURE APPLIANCE FEEDERS SPECIAL REC'PT TIME CLOCKS BELL UNIT HEATERS MULTI.OUTLET DIMMERS AMT. K. W. OIL H. P GAS H. P. AMT. NO A. W. G. AMT. AMP AMT. AMPS. TRANS. NO AMT, H. . ST P. SYSTEMS FEET WT WATTS 2 F 1 20 1 SERVICE DISCONNECT NO, OF S E R V I C E M11. AMP. TYPE METER EQUIP. 1.02W11 0 3W 3 $ 3W 3.e 4W NO OPF CCb'. COND. A W G. NO. OF HbIEG A NO. OF NEUTRALS A. W G. ER OF CC. COND. OF HbIEG OF NEUTRAL 1 200 CB 1 % 1 3/0 1 3/0 OTHER APPARATUS: WELL PUMP PADDLE FANS-4 140TORS:1-F H.P.,4-F H.P. G.F.C.It-10 SMOKE DETECTOR:-1 G & S CONTRACTOR LIC.#578-E BOX 215 SOUTHOLD, NY, 11971 GENERAL MANAGER 11 Per This certificate must not be altered in any manner; return to the office of the Board if incorrect. Inspectors may be identified by their credentials. COPY FOR BUILDING DEPARTMENT. THIS COPY OF CERTIFICATE MUST NOT BE ALTERED IN ANY MANNER. ENERGY CODE CALCULATIONS (For Non-Electric Heat) Design Criteria 6,000 Degree'.Days O.A. 10°F I.A. 70°F FOR., ~F/Y/e lj h~jo~ PER: 411741 ham. 1 tr DATED: DESIGN THERMEL REMARKS SUBSYSTEM AREA .pull RATING Exterior Walls (Opaque) Glazing ~8 5' 5s8 ~L p czrnl CF' 33 - L Doors - Ceiling/Roof (Opaque) sZ3 ~3 3 + V~ Skylights % Floor 0 4 Foundation Walls Slab Insulation TOTAL + Notes: Building Envelope Systems to meet requirements of 7815.2 HVAC Equipement to meet requirements of 7815.11 HVAC Systems to meet requirements of 7815.12 Duct Systems to meet requirements of 7815.13 Ventilations Systems to meet requirements of 7815.14 Insulation of Piping Systems to meet requirements of 7815.15 Service Water Heating Systems & Equipment to meet requirements of 7815.21 Electrical & Lighting Systems & Equipment to meet requirements of 7815.31 , 1' of NEW), To the best of my knowledge, rc 11 , 09g belief, & professional judgement, these plans are in r compliance with the code. n s'•' W~s FESStO~P~ j A-1 Town Hall, 53095 Main Road 1, Fax (516) 765-1823 P. O. Box 1179, Telephone (516) 765-1802 Southold, New York 11971-,,,- = 1 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD C E R T I F I C A T I O N / DATE O ~5 Building Permit No.// Owner: .~i»,. /y -/Y" ///o/7 (please print) Plijmher: (please print) / I certify that the solder used in the water supply system contains less than 2/10 of 1% lead. P1 b s Sig ture) Sworn to before me t pis - day of 19 BARBARA STEANO Notary Public, Slate of New Yak Notary Public, County No.OIST4844752 CualiW in Suffolk C M90 ` - CanffLWoa Expires Sept. 3D. 191q FORM NO. 3 TOWN OF SOUTHOLD BUILDING DEPARTMENT TOWN CLERK'S OFFICE SOUTHOLD, N.Y. NOTICE OF DISAPPROVAL Date ..August 15 ..............119 94... Ann M: Shannon (c/c Raymond Nine) P.O. Box 408 Marratooka Road Mattituck NY 11952 PLEASE TAKE NOTICE that your application dated A.u.9 usx..7 19 9A.. forpennitto construct.addition .............................................at Location of Property .......2775,1agMgtooka, Road Mattituck House No. Street Hamlet County Tax Map No. 1000 Section ......123..... Block 2 Lot 26, , , . . Subdivision none........ Filed Map No . Lot No. . is returned herewith and disapproved on the following grounds R-40 Zone District. Article IIIA, Section 100-32, Bulk Schedule, requires a maximum lot coverage at 20%. Proposed addition will exceed 20% lot coverage requirement. Action required by Board of Appeals. Lot size: 6854+-Of. Twenty percent = 1370.80+- (as exists) ARy.J.Rereasq. of building. area, will. axcaad.20% u11 g Inspector v RV 1/80 ,e2::> r,y,4 lkl+ n Itlt o Ij r III) II ~ ~ I jy i r 4('. it i f W IU 1`~ W, t 1 tit s I~ y N. -!'~II(~' Jli(~1'; LV i rk,. 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I/%111~11d r~~~N I . ti , 1 -1 ' l r L) tr.r In >rl Via, r, L;t 0 ,rt It Ik ' G lui i ? `4 •rn 'ft; it1i~ I:S_ ! r84. -f ly i, i `ll j rl. ~ L a I j U -f4 C-) 3 00 E. r--:_. <-<.- v'~.r~r ~y ate ' • i) j'.. I i DIJ =.S 1 U) T G Q i 1994 F4[ s BLDG. DEPT. TOWN OF SOUTHOLD ' ' & Town Hall, 53095 Main Road Fax (516) 765-1823 P. O. Box 1179 Y Telephone (516) 765-1802 Southold, New York 11971 OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 14, 1995 Ms. Anne M. Shannon 83-04 259 Street Floral Park, NY 11004 To Whom This may concern: We are unable to complete your Certifi.cate.of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. No Health Department Approval on file. No final inspection has been made. xx No,Plumber,Solde,r,Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22343-Z Please contact our office on this matter. Thank you for cooperation. 'SOUTHOLD TOWN BUILDING DEPT. * - 2 CO'S REQUIRED FOR THIS PERMIT. ADDITION & ACCESSORY 's'Ir i ;t I M= in Inc YJ (TI `liT~+r1 ~r)~ ril I-'` I y'd4. i II i I C ~ (n ~ I 6. I kn 5.3°U3~Cxl~~E. k ~i0-.Q~r.,,..~• •:.~s _.,rr,::,,.1 . C 'i I _i... 1, I ~ . DE TOWN OF SOU HOLD O~~gpFFOJOlt o~ Gym C4 = Town Hall, 53095 Main Road p • Fax (516) 765-1823 Telephone (516) 765-1802 P. 0. Box New York 9 11971 Southold, N OFFICE OF THE BUILDING INSPECTOR TOWN OF SOUTHOLD September 14, 1995 Ms. Anne M. Shannon 83-04 259 Street Floral Park, NY 11004 To Whom This May Concern: We are unable to complete your Certificate of Occupancy because of the following reasons: xx An application for Certificate of Occupancy is not on file. (Enclosed) xx No Underwriters Certificate on file. xx The check's are not on file. 2 @$25.00* No Health Department Approval on file. No final inspection has been made. xx No Plumber Solder Certificate on file. (All permits involving plumbing being issued after April 1, 1984). BUILDING PERMIT # 22343-Z Please contact our office on this matter. Thank you for cooperation. SOUTHOLD TOWN BUILDING DEPT. * - 2 CO'S REQUIRED FOR THIS PERMIT. ADDITION & ACCESSORY t ~7 I ,~,;ri CoiyeGQH y L.1 m - .j Il I~t~ar r) 1 Lj'(j, ~ its. !ri. 8 5. c u U ~ - D IJ d~ )i_S iU? • 1 . , i ~ 4 t, . r<7 ~ t ~8 [any 1 D ! ors I 1 1994 4 BLDG. DEPT x.. _ . L TOWN OF SOUTHOLD o~ ~10 2~- 765-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN LATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS: /-,Z22 cz2 DATE G INSPECTOR 76S-1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION I ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] IN ATION [ ] FRAMING [ FINAL [ ] FIREPLACE & CHIMNEY REMARKS:® DATE INSPECTOR 765.1802 BUILDING DEPT. INSPECTION [ ] FOUNDATION 1ST [ ] ROUGH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL [ ] FIREPLACE & CHIMNEY REMARKS: e DATE t/ ! INSPECTOR / - 1- 11 - 2; M-1802 BUILDING DEPT. INSPECTION H PLBG. [ ]FOUNDATION 1ST [ 7SULATION [ ] FOUNDATION 2ND [ [ ] FRAMING [ ] FINAL REMARKS: DATE 5 INSPECTOR a~ 765-1802 BUILDING DEPT. INSPECTION [OUN ION 19ST [ ]ROUGH PLBG. e"46 UNDATION 2ND [ ] INSULATION [ ] FRAMING [ ] FINAL 1 REMARKS: / ~-)iU k Q,G~L DATE INSPECTO M-1802 BUILDING DEPT. INSPECTION. ( ] FOUNDATION 1ST [ OUCH PLBG. [ ] FOUNDATION 2ND [ ] INSULATION [ y"FRAMING [ ] FINAL REMARKS: DATE S y INSPECTOR ~1 ~gOFFOLkC O APPEALS BOARD MEMBERS Southold Town Hall Gerard P. Goehringer, Chairman H ,z 53095 Main Road Serge Doyen, Jr. "p P.O. Box 1179 11971 James A. Vzio, illa - y'~0( s~, ~a0~ Southold, Fa (516) 765-1823 Robert Richard C. Wilton Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD September 16, 1994 i~ 0WN 7) Mrs. Anne M. Shannon ? 83-04 259th Street Floral Park, NY 11004 BLDG. Re: Appl. No. 4267 - Variance for Deck Addition TN IL~.FU 1THC1) D Dear Mrs. Shannon: Please find enclosed a corrected copy of the findings and determination rendered by the Board of Appeals and filed this day with the Town Clerk's Office concerning your variance application. The correction shows that the project approved a fully enclosed addition rather than a deck addition. Copies have been forwarded to the County Planning Commission and Southold Town Building Department as well. Very truly yours, GERARD P. GOEHRINGER CHAIRMAN 1k Enclosure Copies of Corrected Decision to: Building Department L- Suffolk County Planning Commission Mr. Raymond Nine • • ~~SpFFO(KCOG APPEALS BOARD MEMBERS Southold Town Hall Gerard P. Goehringer, Chairman w m 53095 Main Road ® 4$1 P.O. Box 1179 Serge Doyen, Jr. Z*P James Robe t A. Villa -'y~1101 ~a0~ Southold, 765- 71 1823 Richard C. Wilton Telephone (516) 765-1809 BOARD OF APPEALS TOWN OF SOUTHOLD ACTION OF THE BOARD OF APPEALS Appeal No. 4267. Application of ANNE M. SHANNON. Variance to the Zoning Ordi- nance, Article IIIA, Section 100-30A.3 for permission to construct addition which will exceed 200 lot coverage. Location of Property: 2775 Marratooka Road, Mattituck, NY; County Tax Map Parcel No. 1000-123-2-26. WHEREAS, after due notice, a public hearing was held on Septem- ber 7, 1994, at which time all comments were received and testimony recorded; WHEREAS, Board Members have viewed the area and are familiar with the premises in question, its present zoning and the surrounding areas; and WHEREAS, the Board made the following Findings of Fact: 1. This application is for a variance from the lot coverage requirements of the zoning code limitation at twenty (20%) percent of the total lot area. 2. Proposed in this project is an • addition of a size 14 ft. by 38 feet at the rear (easterly side) of the existing dwelling. The square footage of the existing buildings is given at 1370.80+-. The lot size is 6863 (60.2 x 114 ft. average), which allows a lot coverage of 1373 (or 200 of the lot). The existing square footage together with the proposed addition is given at 1903 square feet, which is 530+- ft. over the maximum permitted by code. This results in a percentage of 27.7°% (6863/1903). 3. The Board finds: (a) the circumstances are unique to the property which is due to several factors: its substandard size of 6,863+- square feet as preexists the zoning requirements; the new construction is a minor project, for a residential addition; (b) the relief requested is substantial in relation to the other properties in the area; however this lot is the smallest lot in the neighborhood; D , 1 Page 2 - Appl. No. 4267 Application of ANNE SHANNON Southold Town Board of Appeals (c) the relief, as requested, will not alter the essential character and is found to be in harmony with the intent of zoning, and shall comply with fall other regulations; (d) there) is no other method feasible for appellant to pursue other than a variance; (e) the ~elief requested will not create an undesirable change in the character of the neighborhood or a detriment to nearby properties ; (f) the grant of this variance will not have an adverse effect or impact on the physical or environmental conditions in the neighborhood or district since there are no sensitive wetland areas in close proximity; (g) in view of all the above factors, the interests of justice will be served by granting the relief for an additional 532 square feet as'',a maximum lot coverage of 27.7 percent, and as requested. Accordingly, on: motion by Chairman Goehringer, seconded by Member Dinizio, it was RESOLVED, to !,GRANT the variance requested, as described above, with the understanding that future proposal to expand any building will require la variance as to the lot coverage requirements, and provided further that the existing garage shall be relocated pursuant to a building permit to a conforming location (as agreed by applicant at hearing).: Vote of the Board: Ayes: Messrs. Goehringer, Dinizio, Doyen, and Villa. This resolution was duly adopted. (Member Wilton was absent.) lk GERARD P. EH GER RECEIVED AND ,FILW BY HAIRMAN THE SOUTHOLD TOWN CLERK DATE 9-i5-~Yy HO' R . 'o a~* -'AZ wk-5 1 Town Clerk, Town cqf Southold i C f I' v ~i~~b~roCL4~~aCti~.~$w i~,t•'~..A~b"+~~~'i!;•o;'y'.~ i Ali ~ ~ I I ~ ~ ~,~J.9 ai `E s, a'` M1V . w Y « t ~ b~ h ~ p Q `J 'Y3. a Sin _ 5 S t i eY•i Cti pPR44 ° A Fr (rl it0. I~~iy. ^ = gg ~3~gi ~ m x O Asti ~ ll~t9 ` " ° O n « N m H zsy5R I ^1 m' 5 s. ;4• m xS n - 'o 5Y .NrP0.p~0t « ° Y' . j p N O « t I~ x ^ mO ~ S t t gl ° x 4 Lt ' 130 /n n / Ri 1 j d 1 S. t ? a= a N O ~ • •J~ gyp- f wl;• TQ ~ Z 6~x O A E i n' ~ \ L ab Y s If j~ p' • ' ~'o C rt ~ ~3 ` L • to 'ti rA Y 5 D O Z PV : P n" k i ~ ~ P• O«S ~9ATk I I I 'y c„ a x ~ 4:" u D [~6~pd 1 2 g 199a rtn DEPT. 0 st,. _ _ _60,1FD OF 11EALT11 FORMNO.1 3 SETS OF PL.\:i5 TOWN OFSOUTHOLD SURVEY BUILDING DEPARTMENT CHECK . TOWN HALL SEPT LC FOR,[ SOUTHOLD, N.Y. 11971 TEL.: 765-1802 NO 1 FY ; GG CALL Examined . O !•l5 19g MA L L TO: Approved Xpermit No. Fem.?.~~T T . p Disapproved a/c ilding~spector) APPLICATION FOR BU,'LDING PERMiT Date INSTRUCTIONS a. TMs application must be completely filled in by typewriter or in ink and submitted to the Building Inspector, with : sets of plans, accurate plot plan to scale. Fee'according to schedule. b. Plot plan showing location of lot and of buildings on premises, relationship to adjoining premises or public street or areas, and giving a detailed description of layout of property must be drawn on the diagram which is part of this appli cation. c. The work covered by this application may not be commenced before issuance of Building Permit. d. Upon approval of this application, the Building Inspector will issued a Building Permit to the applicant. Such permit 'shall be kept on the premises available for inspection throughout the work. e. No building shall be occupied or used in whole or in part for any purpose whatever until a Certificate of Occupancy shall have been granted by the Building Inspector. APPLICATION IS HEREBY MADE to the Building Department for the issuance of a Building Permit pursuant to the Building Zone Ordinance of the Town of Southold, Suffolk County, New York, and other applicable Laws, Ordinances or Regulations, for the construction of buildings, additions or alterations, or for removal or demolition, as herein described. The applicant agrees to comply with all applicable laws, ordinances, building code, housing code, and regulations, and to admit authorized inspectors on premises and in building for necessary nspectj0 s. 4 D (Signature of applicant, or name, if a corporation) (Mailing address of applicant) 41)77 "roe"r, /X/ State whether applicant is owner, lessee, agent., architect, engineer, general contractor, electrician, plumber or builder. Ja!ti. Name of owner of premises t (c...', J/4!Ql1/ . . . . . . . . . . (as on the tax roll or latest deed) applicant is a corporation, signature of duly authorized officer. (Name and title of corporate officer) Builder's License No. ..0. • • . . . . Plumber's License No, N14 , „ • , • , • , • , Electrician's License No. ~/~`1 . Other Trade's License No. /ll........... • , • , . . Location of land on which proposed work will be (lone . y ..a,....:............... . House Number Street Hamlet a Lot n; (t County Tax Map No. 1000 Section Block ...°.~1......... L ~ Subdivision . Filed Map No. Lot (Nmnc) State extSting use and occupancy of premises and intended use and occupancy of proposed construction: a. Extsiml- use and nccu nancv b. Intended use and occupancy `,j!!~r' /T!! G 3 Nature of work (check which,aPPlicable): New Budding Addition Alteration Repair Removal,.- _ ;t;.,:•. Demolition . Other Work , . 4. Estimated Cost (Description) 5. If dwelling, number of dwellirj (to be paid on filing this application) If garage, number of cars ° units , . , . , , • Number of dwelling units on each floor . • 6. If business, commercial or mrked.oc$ lt" Height nnturI :uul extent of caclr t [.c 7 of use .~A 7. Dimensions o. existing stnrctures, if any; Prop("'..°': !tear R. , , , Depth 2 ¢Height Number of Stories X Dimensions of same stnrcture with alterations or additions: Pmnt , , . /T... Rear FT Depth ....3.'1- ,/7..... .~7.... . Height , Number of Stories . 8, Dimensions of entire new construction: Front N.ff , , , , • : ° F'iciltt Rear Depth g Number of Stories . . . . . . • - 9. Size of lot: Front /P FT" Rear 10. Date of Purchase F.~ ,i,.•, Depth . Name of Former owner ~rif7f{t"F'!rtiE. r SEi/~T . . ]I. "Lone or use district in which Premises are situated t 2, Doc;s nrnpncN<i eorrstruction vl~late any zoning law, ordinance or regulation: • . • • 1 -.1 : ' ' ' ' ' ' • • . • , • • , Will excess fill be removed from premises: Yes 14. Name of Owner of Prenyyises . . . . . . . . . . . . . . . . Address o. Will lo[ be regraded ~ , ..............Phone No.......... , Name of Architect 'Ild Address . Phone No. Nance of Contractor r? e . . ~....neNo. N... ,rNlt!S'~? Address >`„/QPES~' 15. Is this property within1300 feet of a tidal wetland? *Yes o *If yes, Southold 'Town Trustees Permit may be required. PLOT DIAGRAM Locate clearly and distinctly all buildings, whether existing or proposed, and indicate all set-back dimensions from property lines. Give street and block number or description according to deed, and interior or corner lot show street names and indicate whether . rATE OF NEW YO tK IT S G 11, $ QUNTYn( Jn1E!~......S~t0.h:n S 5'--^ heing dul S<1e y sworn, deposes and says that } is the applicant (Name of individual signing contract) ove named, is the n/ X.).................................. (Contractor, agent, coporate officer, etc.) ° ' ' ' ' - said owner or owners, and is duly) authorized to pcrforrri w have performed the said ',vork and to make and file this :rlication; that all statements contained in this application are true to the best of his knowledge and belief; and that the rk will be performed in the manner set forth in the application filed therewith. orn to before me this 7' Z/ . , ....day or. 19 q / 'ar} Public . .............!x,,, County (Signature of applicant) dAMMY°k1UFIP f N61ery No.52151a j Quelified in Suffolk Cowry / Commission Expires Pe6 .1.9/ v Nt1:IV vH6 2~I~ *'iDGr - FNS LOUVEN 12 f' ~ r ~ 7Bf 3t01 \ hL Pfv GD i i t 12"WIT I n ham' I 9i~ / LV~VENT i j r,!'Iw" R15 i E,x-sr ='Q 2x4 7 GIB IJ ..r 1 -v 'fr°PLY i k 9%6 ! ti ( 1Fco ~Ih 7P sub CrA YY Stu. - S"L aF is co r i 4-1rd5 NIH '~~f - R~SN`T _-LL~Vf~~l Q1~ lrXr57 CELLA2 ~ /dENI D ! pR ov onF-r+tG- i OCCUPANCY n USE IS UN"MFUL Ti-* A' - WITHOUT CERTIFICATE TE ATION OF OCCUPANCY PLUM,BERCfRTIfICATION r, ON LEAD CONTENT BEFORE WFORE ONUEkWRp IpFD fl011E ~S y~~//j~/~ ~Q`V~1) CERTIFICATE OF OCCUPANCY !IPANCY I TER V pU ~1 c L t i L!, P_-ASOLDER USED IN WATER INNO - - - SUPPLY SYSTEM CANNOT INNOT r EXCEED 2110 OF 1% LEAD. iLEAD. !3F C<~i~Fh'?AS C'PEF?F - . f: rS I" ir~-,Ifs R"~c;~nlt nrPAR e ~T ~T If OOPPer tubing is used for water distributing 14, !u i8(;2' 'k nrq: P'M FOR THE ahem; piping shall be F61_1i`k'J41dL, IPk;PEC770N5 ~66'(© _~C2i Cf' of tYPel K or L onl r. Fri*FJATt0ra . RNOREQUIRED FU! POURED aONCRETL S 6q~ Z. ROUCGH - FRAMING & PLUMBING iWSULAlION (0 - " f UMWIG FIN;:L - CONSTRUCTION MUST ' ALLRu1A mwwm BE COMPLETE FOR C.O. YIIUEII {JIBS~ /NE/~E~O TESTWO BEFORE CONERPIO ALL CONSTRUCTION SHALL MEET THE REQUIREMENTS OF THE N.Y. ap. T I STATE CONSTRUCTION & ENERGY I 4 Cr DLS. NOT RESPONSIBLE FOR k ~ OESIfiN OR CONSTRUCTION ERRORS I q E ' ~ I 1*1 I F Z:? I 1,.1-. N a i ue r I. P Plione 477-0400 W a22 1 CiR EN'PORT,N.Y.IJS44 p~~EesswN~` ANN. 8 k No E~ l QWC CLE'VATION ctrp_SS .5~ L :d ? 3 F 7 17 v-- a . i it ~Ql,2'' r' ~F t4' . t 4 v AIR RL' Lucti7E /JOT SU6yESr 11 W. 4"dBINET NoT f NO'T FR~NFp CAe 6ET 1 . SYEP 5 et ''reYR pm *ae SW6 N; 3,0410-G - I 41 s t 0 r D y 17- ~1ID 'k,' FLIP n~ YI ti* 1 V ' W - CIE' 17::/~.( r-ECC;' m - --'IEgEy,h- AweovE NMirrok W7 1~ ~ ~ ICI _ 0 PIPE _ _ _ _ I -}*c - , eu: rta.a 'M Bprrr' 2 t4NLL BATS ' ~T 'SA lam. 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